Urgent info needed!!! Help

[capt]

Hello forum

I would be grateful if someone can help with some vital info. my details are below

I underwent a Minimally invasive surgery for a Aortic valve replacement on 26th Oct 2011. I am 38 years old and have a bio-prosthetic valve. I suffered a Congestive heart failure Grade 4 9 days after the surgery and the Doctors had to remove over 2 liters of fluids from my Peri-cardial cavity and from my lungs. I was in the CCU for 20 days and then got better.
My EF improved to 30% over the year which I still hold.
As I also suffer from HCV genotype 3 which was diagonized 4 years ago, I was put on interferon B and ribavirine for 24 weeks starting 16th Oct 2012. I have completed 13 dozes and my viral load is now zero. I am still to take 11 more injections which I should complete by March 2013.

I started having eptopic beats and the holter report came back as VPFs being at 10% of the 24 hour value which my doctor said was significant.

I am on a huge dose of medicine that includes - 1 cap of 2.5 mg of cardiopril, 3.125 at 1 -0 -1 of cardivas, 1 eplerone 25 mg, lasix - 80 mg, metolazone -5 mg, 500mg of carnisure along with vitamins and fish oils.

I was diagonized with a grade 3 CHF now and my doctors are worried about my LV dysfunction and global hypokenisia. I started having grade 3 symptoms on breathlessness, lightheadedness, fatigue and irregular heart beat.

My doctors say that the only option is now a heart transplant. I am really worried as I need to start a family. another option is a cardioverter. But I am ruled out of this option due to my ECG reports.

I am on a low sodium diet and water restriction. however, I do not have swelling or retaining of water due to the diuretics that i take

What is way forward? can someone help!!!!!!!!!!!!!!!!!!111

 

[ski girl]

Capt none of us are doctors and I highly doubt any of us have had a similar experience to yours so we can't even say 'when I had this here's what I did'.

Listen to your doctors, get a second opinion - best advice I can give! Good luck

 

[metronome]

Like ski girl said, we are not physicians, perhaps some forum members are but I am not. I do have some questions though.
What was your physical condition prior to surgery and what precipitated this event or what were your symptoms ? Did you have a history of heart disease ?
When you had surgery did they perform any CABG's ?
You realize a 30% EF is considered very low ?
With Hepatitus C, how is your liver ?
I'm not familiar with VPF's, do you mean PVC's ?
Now, your meds.
The Cardiopril (ACE inhibitor) and Cardivas (beta blocker) seems appropriate given your history.
But this is where I get concerned. You are taking three separate diuretics !
Eplerenone, a mineralocorticoid receptor antagonist. Yes, it is indicated for LV dysfunction.
Lasix, a very effective loop diuretic.
Metolazone, a thiazide diuretic.
Reading through the literature of these three drugs, you will find several contraindications and warnings relative to each other and the ACE inhibitor you're taking. Not to mention the toll the HCV is or has taken and how it could be affecting the metabolism of these meds.
You state you have no swelling or edema... I bet you don't ! Do you know what your electrolye values are... like within the last one or two days.
And why are you taking Carnisure ? Do you have low levels of carnitine ?
Global hypokinesis with 30% EF is indeed serious.
Are you seeing a number of cardiologists or just one. Pulmonologist ? Employee Insurance, Private Insurance, VA, charity etc.??

 

[capt]

Urgent info pleae!!!

Urgent info pleae!!!

hello metronome and ski girl

Thank you for the reply. I understand that you are not physicians but this forum has been very helpful as there must be numerous patients or know of someone who is suffering from a similar condition.

Let me try to answer your questions.
1. I did not have any illness or any heart condition prior to this event. I was a Pilot with Continental Airlines and a avid climber and skydiving. The doctors are of the opinion that I caught this infective endo-carditis by food poisoning.
I have no history of blockages and no CABG was performed.
The doctors say that 30% is pretty low with the complications of global hypokenisia and also now with the symptoms.
MY liver is normal now and even it has some scratches, with the interferon, it has stopped from further deterioration.
VPF is the missed beat/ couplets/ or ventricular beat component.

But this is where I get concerned. You are taking three separate diuretics !
Eplerenone, a mineralocorticoid receptor antagonist. Yes, it is indicated for LV dysfunction.
Lasix, a very effective loop diuretic.
Metolazone, a thiazide diuretic.
The other issue now is that my doctors have increased my lasix to 120 mg along with other medicine.
OK, that is an issue that I shall try to talk to my Cardio surgeon and my cardiologist.
My electrolytes are normal.
And why are you taking Carnisure ? Do you have low levels of carnitine ? No, I do not have low levels of carnitine. I should ask my doctor about it.
Global hypokinesis with 30% EF is indeed serious. That is the problem too.
Infact, along with the increase in lasix, my doctors have started me on Cardarone 200mg twice a day((amiodarone) (Cordarone X tablets contain the active ingredient amiodarone, which is a type of medicine called an antiarrhythmic. (NB. Amiodarone tablets are also available without a brand name, ie as the generic medicine.) Amiodarone is used to control abnormal heartbeats.

I am seeing my primary cardiac surgeon who is considered the best ( approx 50,000 surgeries) along with my cardiologist and a Interventional Cardiologist and Electrophysiologist and my hepatalogist and gastro-entrologist. Apart from this, I regularly consult with other cardiologists who have been giving me different opinions. I pay for my hospital and with insurance co-pay, I have spent over $200,000 as of date.

I have a team of doctors seeing in co-ordination with each other regularly.
Infact, today, I had lots of breathlessness and my doctors suggested admission. I am yet to go and will go tomorrow morning.


Please do help